[Drug-induced gastrointestinal bleeding]

Area of Science:

• Geriatrics
• Pharmacology
• Gastroenterology

Background:

• Gastrointestinal bleeding (GIB) is a frequent and serious complication in the elderly population.
• Drug-induced causes are common, necessitating careful medication review in this demographic.

Purpose of the Study:

• To summarize the common drug-induced causes of gastrointestinal bleeding in older adults.
• To outline primary and secondary prevention strategies for drug-induced gastrointestinal bleeding.

Main Methods:

• Literature review of common medications associated with gastrointestinal bleeding.
• Identification of preventive measures for gastrointestinal bleeding in elderly patients.

Main Results:

• Key drug classes implicated include non-steroidal anti-inflammatory drugs (NSAIDs), antiplatelet agents (e.g., acetylsalicylic acid, clopidogrel), and anticoagulants (e.g., vitamin-K antagonists, heparin, direct oral anticoagulants).
• Combination therapy with antiplatelet agents or concurrent use of antiplatelet agents and anticoagulants significantly elevates GIB risk compared to monotherapy.
• Helicobacter pylori eradication and proton pump inhibitor (PPI) co-medication are established prevention options.

Conclusions:

• Older adults are particularly vulnerable to drug-induced gastrointestinal bleeding.
• Awareness of causative medications and risk stratification is crucial for preventing GIB.
• Prophylactic measures, including H. pylori eradication and PPI use, can mitigate bleeding risk.